Provider Demographics
NPI:1790353183
Name:CASE, CHRISTY ANN (ARNP)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:ANN
Last Name:CASE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-558-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:106 W JOHN ROWAN BLVD
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2636
Practice Address - Country:US
Practice Address - Phone:502-350-4799
Practice Address - Fax:502-350-4798
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYF06210181363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily